Grand Rounds 1.11.11 | It’s Complicated

When when I read the posts from this week’s grand rounds, I am astounded at how advanced, how intense, how personal, how vast, and also how amazingly complicated health care here in America is. It’s so complicated that probably only the most astute health care observers and healthcare management degree students will even understand every post below.

As you read through the best posts from the medical blogosphere for the week, just think about how amazing all of this is – health care leads to all kinds of misconceptions, frustrations, discoveries, inspiration, opportunities, tragedy, and humor.

(note to FDAzilla blog regulars: this week we take a break from “working smarter with the FDA” to take in a bigger picture of health care, and everything that happens “downstream” of our FDA inspections & approvals)

Some Princeton scientists have created proteins from “scratch”. Not your run-of-the-mill proteins, but the kind that can potentially sustain life. Yet again, it’s the magic of nanotechnology – and we’re just getting started.

While you finish swallowing the little bit of vomit that just arrived in your mouth, here’s a really interesting post of how often the words, “nausea, vomiting, and diarrhea” – the three dreaded symptoms of an acute gastroenteritis, appeared in books over the last 300 years. (that’s right, Google documents everything). And speaking of lots of data, FDAzilla has taken the millions of adverse reactions reported to the FDA related to all medical devices, and have made it readily web-searchable here.

These next 3 posts are a great microcosm for why health care is so amazingly complex – it’s because so many players have so many motives. Well, actually, it’s just 2 motives, really – passion for profit and passion for life. All the rage recently in the health care policy arena has been about Accountable Care Organizations (a refresher on what they are). Here’s a take from someone who’s kicked the tires a bit. One blogger is skeptical of JCAHO’s motives for making a recommendation to screen all patients for depression when they’re admitted to the hospital. And we all heard the “news” of the great autism-vaccine fraud. Mixed motives + a couple of celebrities advocates = an army of unvaccinated kids. Ugh.

One reconstructive pelvic surgeon/urogynecologist blogged on the Prolene mesh for pelvic organ prolapse repair. This mesh doesn’t work well for some procedures, but it seems to perform superbly for certain types of procedures. The FDA will likely just yank it off the market completely. Sometimes these recalls are and have to be of the baby-with-the-bathwater kind. It’s just too complicated to delineate the different applications, or is it?

What’s so complicated about a 10-minute visit to your primary care physicians? Apparently, that visit takes 8 people 45 minutes of work.